Lucidi C, et al. - Researchers attempted to ascertain if a low muscle mass could deteriorate the outcome of cirrhotic patients with sepsis. Data displayed worsening of the prognosis due to low muscle mass in cirrhotic patients with severe infections, which was evident in patients with Child A-B cirrhosis in whom the coexistence of low muscle mass and sepsis resulted in a negative impact on mortality. This was similar to that observable in all Child C patients with sepsis.

Methods

• The enrollment comprised of consecutive cirrhotic patients hospitalized for sepsis.
• Candidates were classified for the severity of liver impairment (Child-Pugh class) and for the presence of “low muscle mass” (mid-arm muscle circumference<5th percentile).
• A scrutiny was performed of the development of complication during hospitalization and survival.

Results

• A total of 74 consecutive cirrhotics with sepsis were reported, out of which 43 patients presented with low muscle mass.
• It was noted that severity of liver disease and characteristics of infections were similar in patients with and without low muscle mass.
• A higher tendency of mortality was found in patients with low muscle mass (47% vs 26%, P=.06).
• In the multivariate analysis, low muscle mass (P < .01, HR: 3.2, IC: 1.4-4.8) and Child-Pugh C (P < .01, HR: 3.3, 95% IC: 1.5-4.9) were identified as independent predictors of in-hospital mortality.
• Child-Pugh A-B patients illustrated higher mortality among those with low muscle mass vs those without (50% vs 16%; P=.01).
• Findings unveiled similar mortality rate and the incidence of complications between malnourished patients classified in Child-Pugh A-B and patients in Child-Pugh C.